Cephalalgia : an international journal of headache
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In previous studies we found that high-frequency somatosensory oscillations (HFOs) reflecting thalamo-cortical activation were decreased in migraineurs between attacks and that high-frequency repetitive transcranial magnetic stimulation (rTMS) was able to normalize the habituation deficit of visual evoked potentials (VEPs). Here we study the effects of activating (10 Hz) or inhibiting (1 Hz) rTMS on conventional low-frequency (LF) and high-frequency somatosensory evoked potentials (SSEPs). ⋯ These data confirm for SSEP that excitatory rTMS can normalize habituation in migraine patients and show that this is accompanied by early an HFO increase, which is thought to reflect thalamo-cortical activity. Taken together with similar effects we observed for VEPs, this finding supports the hypothesis that dysfunctioning thalamo-cortical loops may be responsible for the interictal habituation deficit in migraine.
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Randomized Controlled Trial Multicenter Study
Minimal clinically important change on the Headache Impact Test-6 questionnaire in patients with chronic tension-type headache.
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Randomized Controlled Trial
Intranasal ketorolac tromethamine (SPRIX(R)) containing 6% of lidocaine (ROX-828) for acute treatment of migraine: safety and efficacy data from a phase II clinical trial.
Ketorolac is a non-triptan, non-opioid, mixed cyclooxygenase (COX)1/2-inhibitor for short-term management of moderate-to-severe acute pain. This trial evaluated an intranasal formulation of ketorolac tromethamine (SPRIX®) containing 6% lidocaine (ROX-828) for the acute treatment of migraine with and without aura as defined by the International Headache Society. ⋯ Self-administered intranasal ROX-828 was well tolerated. While the primary endpoint was not met, the results provide preliminary evidence that ROX-828 improves migraine pain.
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Randomized Controlled Trial
Efficacy and tolerability of rizatriptan in pediatric migraineurs: results from a randomized, double-blind, placebo-controlled trial using a novel adaptive enrichment design.
Treatment options for children and adolescents with migraine are limited. This study evaluated rizatriptan for the acute treatment of migraine in children and adolescents. ⋯ Rizatriptan demonstrated a statistically significant improvement over placebo in eliminating pain and was generally well tolerated in migraineurs aged 12-17 and 6-17 years.
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Review
Migraine and vascular diseases: a review of the evidence and potential implications for management.
The higher-than-expected incidence of vascular diseases reported in migraineurs suggests that migraine may, in some cases, be a dangerous condition rather than just a distressing but harmless disorder. We provide a systematic review of data linking migraine to vascular diseases. ⋯ Forthcoming guidelines should appropriately recommend supporting migraineurs not only with measures aimed at decreasing headache frequency, thus improving quality of life, but also with general measures and preventive strategies aimed to reduce the overall vascular risk. In fact, headache specialists should take care not only of relieving pain but also of assessing and treating concurrent vascular risk factors, while gynecologists, in particular, should routinely consider the presence and type of migraine before prescribing oral contraceptives.